After months of lockdown, parts of Southeast Asia are leaving behind their "zero-Covid" policy and charting a path toward living with the virus - despite experts' warnings that it may be too early to do so.
Covid-19 swept across the region this summer, fueled by the highly infectious Delta variant, with cases climbing steeply in July and peaking in most countries by August.
Now, governments including Indonesia, Thailand and Vietnam are looking to revive their economies - particularly the vital tourism industry - by reopening borders and public spaces. But experts worry that low vaccination rates in much of the region, and the widespread use of lower-efficacy vaccines including China's Sinovac, could lead to a catastrophe.
Yanzhong Huang, senior fellow for global health at the US-based Council on Foreign Relations think tank, said if vaccination rates aren't high enough with high-efficacy vaccines before restrictions are lifted, health care systems in Southeast Asia could quickly become overwhelmed.
"You're going to see this spike of severe cases then it's going to overwhelm the ICU … beds, ventilators, there's going to be a shortage capacity challenge," he said.
But for much of the public and many leaders across the region, there seem to be few other options. Vaccines are in short supply, and for many Southeast Asian countries, mass vaccination is unlikely to be achieved in the coming months. All the while, as people lose work opportunities and are confined to their homes, families are going hungry.
Jean Garito, a diving school operator in Thailand's Phuket island, said small- and medium-sized businesses are desperate for borders to reopen. He wasn't sure how much longer the country's tourism sector could survive, he added.
"If governments are not able to really compensate businesses for their loss in the short and long term, then yes - if they don't fully reopen, we are all doomed," Garito said.
End of 'zero Covid'
From June through August, many Southeast Asian countries introduced strict restrictions in an attempt to control the Covid wave.
Malaysia and Indonesia imposed lockdowns nationwide, while Thailand and Vietnam put in place lockdowns in high-risk regions. Under these restrictions, millions of people were told to stay at home whenever possible and prohibited from domestic travel; schools closed, public transportation was suspended, and gatherings were banned.
Since then, daily new cases have dropped across the region, though they still remain high. According to data from Johns Hopkins University (JHU), the Philippines is reporting nearly 20,000 cases a day, with Thailand, Vietnam and Malaysia all recording about 15,000 cases every 24 hours. Indonesia's infection rates have declined the most - it's now reporting a few thousand cases a day.
The peak has just barely passed, and vaccination rates are dismally low in some places - but already, some governments are beginning to reopen.
Covid-19 reported cases and deaths
As the pandemic drags on, with communities lifting and reimposing lockdown every few months as families go hungry, people are also experiencing pandemic fatigue. Economic strain aside, governments also face building public pressure to reopen.
It's the "major dilemma" facing scientists, policymakers and world leaders in Asia, Rimal added. "We know vaccines are a major answer, (but) we don't have access to the vaccine, while we see people suffering and facing job loss."
That's why humanitarian organizations like the Red Cross are calling on global leaders to provide more vaccine doses to low-income and hard-hit countries in South and Southeast Asia, he said. But in the meantime, if countries are set on reopening anyway, there's only one thing they can do: strengthen all other aspects of their pandemic response such as public health measures, testing and contact tracing.
"Unless we do this, we will definitely see a surge in cases in the days or weeks to come," he said.
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